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首页> 外文期刊>Surgical Endoscopy >The useful combination of a higher frequency miniprobe and endoscopic submucosal dissection for the treatment of T1 esophageal cancer.
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The useful combination of a higher frequency miniprobe and endoscopic submucosal dissection for the treatment of T1 esophageal cancer.

机译：高频微型探头和内镜下黏膜下剥离术的有效结合，可用于治疗T1食道癌。

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BACKGROUND: There are few published data on the discrimination ability of endoscopic ultrasonography (EUS) among each subdivision of T1 cancer, and overdiagnosis is an unsolved problem that eventually causes overtreatment. The purpose of this study was to verify whether our treatment strategy incorporating EUS realizes a tailored patient management of T1 esophageal cancer. METHODS: This study comprised 20 esophageal cancer patients undergoing 12- to 20-MHz miniprobes for T staging and a 7.5-MHz dedicated echoendoscope for N staging. Initial therapy constituted endoscopic submucosal dissection (ESD) for endosonographically node-negative, mucosal, or slight submucosal cancers and a primary esophagectomy with three-field lymphadenectomy for deeper cancers. If the ESD specimen revealed no cancer involvement of the muscularis mucosa, the patients entered a follow-up program; otherwise, they were advised to undergo a subsequent esophagectomy and three-field lymphadenectomy. RESULTS: Perfect discrimination accuracy was achieved among T1, T2, and T3 cancers. Whether cancer depth was up to the slight submucosal layer or deeper was correctly differentiated in 12 of 14 T1 cancers (86%). EUS categorized all patients correctly into candidates for either ESD or surgery. The pathological cancer depth of the resected specimens revealed that no patients experienced unnecessary overtreatment. CONCLUSIONS: A higher frequency miniprobe is useful for the detailed evaluation of cancer depth, contributing to decision making for treatment options of T1 esophageal cancer. A miniprobe and echoendoscope in combination with ESD provide an appropriately tailored management plan on an individual basis, avoiding unnecessary treatment or indicating radical surgery.
机译：背景：关于T1癌症每个细分领域内镜超声检查（EUS）的辨别能力的公开数据很少，过度诊断是一个尚未解决的问题，最终导致过度治疗。这项研究的目的是验证我们结合EUS的治疗策略是否实现了针对T1食管癌的量身定制患者管理。方法：本研究包括20例食管癌患者，他们接受12到20 MHz的微型探头进行T分期，并接受7.5 MHz的专用超声内窥镜进行N分期。初始疗法包括内镜下淋巴结阴性，粘膜或轻度粘膜下癌的内镜黏膜下剥离术（ESD），以及用于深层癌的原发性食管切除术和三视野淋巴结清扫术。如果ESD标本显示没有肌层粘膜癌变，则患者进入随访计划。否则，建议他们进行随后的食管切除术和三视野淋巴结清扫术。结果：在T1，T2和T3癌症之间达到了完美的判别准确性。在14种T1癌症中，有12种（86％）正确地区分了癌的深度是到达粘膜下层还是更深。 EUS将所有患者正确分类为ESD或手术候选者。切除标本的病理癌症深度显示，没有患者经历过不必要的过度治疗。结论：较高频率的微型探头可用于详细评估癌症深度，有助于做出T1食管癌治疗选择的决策。微型探头和超声内窥镜与ESD结合使用，可根据个人情况提供适当定制的管理计划，避免不必要的治疗或指示进行彻底的手术。

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